Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis

Abstract

Background Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls? Method Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2). Results Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants). Conclusion Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies. Trail Registration number INPLASY202040048.

Effects of physical activity level on quality of life, stress, and dietary behavior in people living with HIV/AIDS: A pilot study

“…[31][32][33] Consequently, HIV infection inevitably lowers the QoL due to a lack of physical activity. [34] The high-activity group was statistically higher than the other groups in psychological well-being and environmental satisfaction among the sub-variables of QoL in our study. These results suggest that individuals with a high level of physical activity increase their mental self-esteem by participating in various social and physical activities; hence, social interaction is carried out smoothly, and stress factors, such as anxiety and depression, are effectively managed.…”

“…[36][37][38] Additionally, it positively affects the physical and mental health of people with HIV. [32,34,[39][40][41] From a physiological perspective, regular physical activity stimulates the parasympathetic nervous system activity, reduces due to anxiety, and ultimately controls anxiety symptoms. [42] Overall, the regular physical activity of people with HIV can prevent anxiety and depression and helps manage stress.…”

Factors Influencing Physical Activity Engagement in Individuals Living With HIV in Nigeria

“…Engaging in physical activity is bene cial to PLWH as physical activity has been shown to impart positive health bene ts such as improved endurance, strength, and vitality, reduced blood pressure and depressive symptoms, and an overall improvement in quality of life and function [7,4]. The physiological health bene ts of physical activity are evident in conditions such as obesity, in which regular PA causes a reduction in fat mass [8]; in sarcopenia, where regular PA improves muscle mass and function [9]; and in osteoporosis, where regular PA improves bone health, thus reducing frailty, the risk of falls and predisposition to fracture [10]. Furthermore, studies conducted on mental health, cognition and memory have reported that there is an increase in blood ow to the brain and promotion of neurogenesis when individuals engage in exercise [11], thus supporting the theory that physical exercise is bene cial to both body and mind.…”

Global trends in depression among patients living with HIV: A bibliometric analysis

“…Leah H et al have conducted a comprehensive review of the link between depression and cognition among PLWH ( Rubin and Maki, 2019 ). Others have reviewed depression in women living with HIV ( Fauk et al, 2022 ), men who have sex with men (MSM; Nouri et al, 2022 ; Operario et al, 2022 ), and interventions for improving depression in HIV patients ( Ibeneme et al, 2022 ), etc. However, these conventional review papers only focus on subdomains and analyze limited relevant literature.…”